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No evidence that family group decision-making is better, or worse, than conventional child protection procedures
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Family group decision-making is used to make decisions about how best to protect children, and support families. It engages the family, extended family, and people in the community around the family, in these decisions. It features an independent meeting facilitator, private family time away from professionals and the prioritisation of family plans. This review finds that the evidence base supporting this approach is of poor quality with no clear finding that it is any better or worse than conventional approaches.
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What is this review about?
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Child maltreatment is a global problem which can affect victims’ health and well-being throughout their life. Debate continues as to effective systems of detection, investigation and intervention for maltreated children.
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This review assesses the effectiveness of the formal use of family group decision-making in terms of child safety, permanence (of child’s living situation), child and family well-being, and client satisfaction with the decision-making process.
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What is the aim of this review?
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This Campbell systematic review assesses the effectiveness of family group decision-making to tackle child abuse. It summarises the evidence from 15 studies in four countries, with most studies being from the USA.
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What studies are included?
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The included studies were about children and young people, aged 0-18 years, who had been the subject of a child maltreatment investigation. Studies had to have used random assignment to create treatment and control groups; or, parallel cohorts, in which groups were assessed at the same point in time.
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Any form of family group decision-making used in the course of a child maltreatment investigation or service was considered an eligible intervention if it involved: a concerted effort to convene family, extended family and community members; and professionals; and involved a meeting with the intention of working collaboratively to develop a plan for the safety and well-being of children; with a focus on family-centred decision-making.
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The review authors found 18 eligible study reports, providing findings from 15 studies, involving 18 study samples. Four of the studies were randomised controlled trials.
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All but four studies were conducted outside the USA: two in Canada, one in Sweden and one in The Netherlands.
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What are the findings of this review?
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Overall, there are few if any significant benefits of family group decision-making compared to conventional treatment, and the quality of the studies in the evidence base is generally poor.
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Four randomised controlled trials found no significant effect on continued maltreatment, reunification of children with families or maintenance of in-home care, engagement with support services and social support.
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The quasi-experimental studies found a statistically significant finding favouring family group decision-making for the reunification of families, but not for any other outcomes. In all cases, there is considerable variation in effects between studies.
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What do the findings of the review mean?
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The low quality of the evidence base, with no clear consistent finding of positive effects, is at odds with the support family group decision-making enjoys in social work practice. However, these findings should not be used to discard the approach, but rather to identify the sources of possible shortcomings in the model whilst strengthening the evidence base.
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It is possible that this disconnect is explained by the theoretical appeal of the approach. Failure to fully implement the model may come from a focus on the planning stage but not the implementation of that plan, or that promised family supports are not forthcoming, or from social workers’ reluctance to hand decision-making over to families.
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More studies are needed. It is important that study designs take account of the many sources of bias, particularly selection bias, to which studies of this topic are prone.
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How up-to-date is this review?
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The review authors searched for studies published up to June 2019.